Psoriasis is an inflammatory skin condition that causes discoloration and irritation. Psoriasis comes in different forms. On light and fair skin tones, symptoms often include raised, red or pink patches of skin that are often paired with a silvery scale.

On medium skin tones, it may look salmon-colored with silvery-white scales. On darker skin tones, the patches may appear as violet or dark brown.

In guttate psoriasis, small, droplet-shaped patches appear on the:

  • arms
  • legs
  • scalp
  • torso

“Guttate” stems from the Latin word for “drop.” Though guttate psoriasis is the second most common form of psoriasis in children, it’s still relatively uncommon. Only about 8 percent of people in the United States who have psoriasis have the guttate form, according to the National Psoriasis Foundation (NSF).

Guttate psoriasis is typically diagnosed in young people. It primarily affects children, adolescents, and adults under 30 years old, though it can occur at any age. Respiratory illnesses or viral infections are common triggers.

Guttate lesions are typically numerous, small, scattered papules and plaques. They often look “drop-like” and are typically 2 to 6 mm papules around the size of a pencil eraser or less.

Guttate psoriasis is not contagious. It cannot not be transferred to others through skin-to-skin contact.

Spots often clear up with minor treatment. Guttate psoriasis can be a lifelong condition for some, or it may later convert to plaque psoriasis.

guttate psoriasis lesions on the back of a young girl with lighter skinShare on Pinterest
Guttate psoriasis is a type of psoriasis that causes small teardrop-shaped skin lesions. Gzzz, CC BY-SA 4.0, via Wikimedia Commons
guttate psoriasis lesions on the upper back of an adult man with darker skinShare on Pinterest
Guttate psoriasis causes small red, scaly teardrop-shaped lesions to form on the skin. Photo by DermNet New Zealand

Guttate psoriasis flare-ups are often sudden. The breakouts typically involve small, discolored marks that intensify and expand. They can cover large portions of the body or may remain in smaller patches.

Guttate psoriasis lesions typically appear:

  • small in size
  • pink, red to brownish depending on skin color
  • separate from each other
  • common on the torso or limbs
  • drop-like lesions, smaller than plaque psoriasis lesions

Outcomes vary for guttate psoriasis. In most cases, guttate psoriasis usually clears up within a few weeks even without treatment.

After that, there are several possible outcomes. Researchers do not yet know how to predict which one will occur:

  • You may never develop it again.
  • It may recur intermittently.
  • It may develop into chronic plaque psoriasis.

According to research, 40 percent of guttate psoriasis cases develop at some point into chronic plaque psoriasis.

Although researchers believe it stems from a combination of genetic, environmental, and immune system factors, the exact cause of psoriasis is unknown.

How is the immune system involved?

In the past several decades, researchers have identified psoriasis as a chronic immune-mediated disease.

Immune-mediated diseases are thought to be triggered by an abnormal immune response. An overly active immune system can attack healthy cells as if they were foreign invaders.

In psoriasis, the immune system targets the skin, which results in the rapid growth of skin cells. This causes the redness and flaky skin typical of psoriasis.

What are the triggers of guttate psoriasis?

Although the cause of guttate psoriasis is unknown, researchers have identified a potential link between bacterial or viral infections and the condition’s onset.

In particular, strep throat and tonsillitis frequently precede guttate psoriasis, especially in children. Infections usually occur 1 to 3 weeks before the onset of guttate psoriasis.

Other factors may also trigger a guttate psoriasis outbreak, including:

  • a skin injury, like a cut, an insect bite, or a burn
  • sunburn
  • stress
  • some medications, including antimalarial drugs and beta-blockers (drugs used to treat heart disorders)
  • smoking

All forms of psoriasis, including guttate psoriasis, can be categorized into 3 different stages of severity. The NPF lists these stages as:

  • Mild. There are only a few lesions, which cover less than 3 percent of your skin.
  • Moderate. Lesions cover between 3 and 10 percent of your skin.
  • Severe. Lesions cover over 10 percent or more of your body, sometimes the entire body.

A dermatologist can gauge the stage of your condition by how much of your skin is covered with lesions as well as its effect on your life. They’ll probably use two popular assessment scales — the Physician’s Global Assessment (PGA) and the Psoriasis Area and Severity Index (PASI).

A doctor can identify signs of guttate psoriasis during a physical examination. They will likely refer you to a dermatologist for a proper diagnosis.

A dermatologist will examine your skin and make note of the affected areas. This mapping will help them track treatments after diagnosis.

They’ll also request a complete medical history to rule out other conditions like an allergic reaction. People often have allergic reactions to the antibiotics used to treat the infection that precedes the guttate psoriasis outbreak.

A dermatologist can usually diagnose guttate psoriasis by examining your skin. But the following conditions may occasionally be mistaken for guttate psoriasis:

A dermatologist may also order a skin biopsy to eliminate other possible contributors to the skin lesions and to help determine the type of psoriasis.

Treatments for guttate psoriasis vary according to the severity of the condition. If it’s your first outbreak, no treatment may be needed. Since guttate psoriasis will usually clear up on its own within several weeks or months, a wait-and-see approach may be fine in some cases.

If you decide to forego treatment, consult with a dermatologist about a diagnosis and to discuss if this is the best option for you. If the condition returns or develops into plaque psoriasis, treatment will probably be necessary.

Topical steroid treatments

Common treatments for psoriasis are topical corticosteroids. They can help reduce redness, itching, and inflammation.

Mild topical corticosteroids are available over the counter (OTC) and might be sufficient for mild cases. Stronger versions are available by prescription only.

Topical corticosteroids can be used on their own, but they’re often combined with other treatments for moderate to severe cases. They are usually applied once or twice per day. Once your condition has been managed, treatment is usually paused.

It’s always best to consult a medical professional before using corticosteroids. Long-term use of topical corticosteroids can cause thinning of the skin, also known as atrophy.

Topical nonsteroidal treatments

Your doctor may prescribe a topical nonsteroidal treatment. Prescription nonsteroidal topical treatments often include ingredients like:

  • Synthetic vitamin D3 derivative. This is used to slow skin cell growth. It’s also sometimes combined with a mild corticosteroid to avoid the side effects of a stronger corticosteroid.
  • Vitamin A derivative. Retinoids are a type of compound containing vitamin A. These compounds may help psoriasis by limiting the production of new skin cells, which psoriasis causes the body to overproduce. Retinoids also help reduce inflammation.

OTC topical treatments

Many different types of OTC topical treatments are available. They’re designed to minimize symptoms rather than treat the condition itself. They’re often intended to soothe redness, soften lesions, or relieve itching.

While there are many creams and topicals found OTC and online, it is important to first be evaluated by a physician so that proper recommendations can be made.

You can find creams for psoriasis online. Other topical products like soaps, shampoos, and gels are also available.

If you’re a little overwhelmed by the large variety of OTC psoriasis products, you might want to look for the NPF Seal of Recognition to help you narrow down your choices.

Manufacturers of these products have submitted scientific data and test results substantiating a claim that their product was created or intended to be non-irritating and safe for people with psoriasis.

You can find an index of these products in the NPF online product directory.


For moderate to severe cases, phototherapy is typically used, either alone or in combination with topical medications. Phototherapy is usually prescribed by a dermatologist.

It involves regularly exposing the skin to particular wavelengths of ultraviolet (UV) light. It can take place under medical supervision in a clinical setting or at home with a phototherapy device, also under the guidance of a healthcare professional.

There are two types of ultraviolet B (UVB) treatment: broadband and narrowband.

Phototherapy is the first-line treatment for moderate to severe psoriasis, either alone, or in combination with other therapies. Both NBUVB and BB UVB can be used.

Other medications

Other medications are used to treat severe or recurrent guttate psoriasis or for cases that have developed into plaque psoriasis. These medications require a doctor’s prescription and include:

  • Cyclosporine. Cyclosporine is an immunosuppressant. These drugs work by suppressing your immune system and lessening its mistaken attacks on your skin cells. It’s typically used to treat severe psoriasis.
  • Biologics. Biologic drugs are made from substances in living organisms and can be made of tiny components like sugars, proteins, or nucleic acids. The several available biologic drugs used to treat plaque psoriasis have not yet been sufficiently researched for treating guttate psoriasis. Currently, biologic therapy is used mostly in the 40 percent of guttate cases that develop into plaque psoriasis.
  • Methotrexate. This medication also suppresses the immune system. It’s typically used in severe cases or when other treatments do not work.

While you may want to try natural treatments or lifestyle approaches to manage your guttate psoriasis, you should first have a doctor conduct an evaluation.

If deemed safe for you to try by a medical professional, natural treatments and lifestyle approaches may be especially helpful if you’re having your first outbreak or your symptoms are mild.

You might try natural treatments along with standard treatments or by themselves. Be sure to check with a doctor before beginning any new treatments.

Some natural treatments you may consider include:

  • Sunlight. Exposure to short periods of sunlight may help reduce your symptoms, but because of an increased risk of cancer, this should be done with the guidance of a healthcare professional.
  • Bath salts. Soaking in a bath with Epsom or Dead Sea salts may help reduce inflammation and wash away dead skin cells.
  • Coconut oil. Coconut oil can soften the scales on your lesions and make it easier for topical medications to get to the skin below.

Avoid using soaps and other personal care products that may irritate the skin. Soaps with added fragrances, dyes, or chemicals can be potential problems.

Lifestyle approaches with health-promoting benefits can sometimes help you manage your guttate psoriasis. These might include:

  • A nutritious diet. Eating nutritious food may help diminish guttate psoriasis symptoms. But no diet can cure the condition. Be sure to talk with a medical professional before making any big changes in your diet.
  • Daily exercise. It’s important to keep up an exercise regimen when you have psoriasis, especially for your cardiovascular health. According to a 2020 study, there’s a link between psoriasis and an increased risk for cardiovascular disease.
  • Meditation or yoga. Meditation or yoga may help calm you down and reduce psoriasis symptoms, particularly itching. These practices may be especially helpful if stress is one of your psoriasis triggers.
  • Professional help. Research has shown that psoriasis can trigger feelings of shame and embarrassment, which can lead to anxiety and stress. If you’re having similar feelings, consider speaking with a mental health professional about your concerns.

There’s no cure for guttate psoriasis, but most cases will clear up on their own within 3 to 4 months. Guttate psoriasis can also recur or develop into plaque psoriasis.

If an outbreak occurs, you should see a medical professional. That way, you’ll know for sure if you have guttate psoriasis and what the best treatment plan is.

A dermatologist can help you choose the form of therapy that best suits your condition and lifestyle. Follow your doctor’s treatment plan and avoid psoriasis triggers when possible.

If you’re using topical treatments, including them in your post-shower routine is the easiest way to remember to use them. Water strips your body of its natural moisture. Applying ointments immediately after a shower can help keep your skin hydrated.

Learning more about your condition can help you manage and treat your symptoms. Consider joining a psoriasis support group and speaking with others who share your diagnosis. The knowledge and tips you can gain about coping with your psoriasis diagnosis can be invaluable.